What are the health benefits of Viagra and L-arginine. How do they interact with each other. What are the potential side effects and recommended dosages. How effective are they in treating erectile dysfunction.

Understanding Viagra: The Popular Erectile Dysfunction Medication

Viagra, also known by its generic name sildenafil, is a widely prescribed medication for treating erectile dysfunction (ED). It belongs to a class of drugs called phosphodiesterase type 5 (PDE5) inhibitors. Viagra works by enhancing the effects of nitric oxide, a chemical that relaxes muscles in the penis, increasing blood flow and allowing for an erection when sexually stimulated.

How effective is Viagra in treating erectile dysfunction? Clinical studies have shown that Viagra is effective in about 70-80% of men with ED. However, its efficacy can vary depending on the underlying cause of ED and individual factors.

Key Facts About Viagra

• Typically taken 30 minutes to 1 hour before sexual activity
• Effects can last for up to 4 hours
• Available in doses of 25mg, 50mg, and 100mg
• Requires a prescription in most countries

L-Arginine: The Natural Amino Acid Supplement

L-arginine is an amino acid that plays a crucial role in the production of nitric oxide in the body. It’s found naturally in many foods and is also available as a dietary supplement. L-arginine has gained attention for its potential benefits in various health conditions, including cardiovascular health and erectile dysfunction.

Can L-arginine improve cardiovascular health? Some studies suggest that L-arginine supplementation may help improve blood flow and reduce blood pressure in certain individuals. However, more research is needed to fully understand its effects on cardiovascular health.

Potential Benefits of L-Arginine

• May improve blood flow
• Could help lower blood pressure
• Might enhance exercise performance
• May support immune function

Combining Viagra and L-Arginine: Potential Synergies and Risks

Some individuals may consider combining Viagra and L-arginine to enhance their effects on erectile function. While both substances can potentially improve blood flow, it’s crucial to understand the potential interactions and risks associated with this combination.

Is it safe to take Viagra and L-arginine together? There is limited research on the safety and efficacy of combining these substances. Some studies suggest that L-arginine may enhance the effects of PDE5 inhibitors like Viagra, but this combination could also increase the risk of side effects, particularly related to blood pressure.

Considerations When Combining Viagra and L-Arginine

1. Increased risk of low blood pressure
2. Potential for heightened side effects
3. Unpredictable interactions
4. Need for medical supervision

Side Effects and Precautions of Viagra

While Viagra is generally well-tolerated, it can cause side effects in some individuals. It’s important to be aware of these potential adverse effects and take necessary precautions when using the medication.

What are the most common side effects of Viagra? The most frequently reported side effects include headache, flushing, nasal congestion, back pain, muscle aches, nausea, and dizziness. These side effects are usually mild and temporary.

Serious Side Effects to Watch For

• Sudden vision or hearing loss
• Priapism (prolonged erection lasting more than 4 hours)
• Chest pain or irregular heartbeat
• Severe allergic reactions

L-Arginine: Dosage and Safety Considerations

L-arginine is available in various forms and dosages as a dietary supplement. While it’s generally considered safe for most people when taken in appropriate amounts, it’s important to understand the proper dosage and potential risks associated with its use.

What is the recommended dosage of L-arginine for erectile dysfunction? Studies have used doses ranging from 1.5 to 5 grams daily for ED. However, the optimal dosage can vary depending on individual factors and should be determined in consultation with a healthcare provider.

Potential Side Effects of L-Arginine

• Nausea and gastrointestinal discomfort
• Diarrhea
• Headache
• Allergic reactions (rare)

Comparing the Effectiveness of Viagra and L-Arginine for Erectile Dysfunction

While both Viagra and L-arginine have been studied for their effects on erectile dysfunction, they differ significantly in their mechanisms of action and overall effectiveness.

Which is more effective for treating ED: Viagra or L-arginine? Viagra has been extensively studied and proven to be highly effective for most men with ED. L-arginine, on the other hand, has shown mixed results in clinical trials, with some studies suggesting modest benefits and others showing no significant effect.

Factors to Consider When Choosing Between Viagra and L-Arginine

1. Severity of erectile dysfunction
2. Underlying health conditions
3. Potential side effects and interactions
4. Cost and accessibility
5. Personal preferences for prescription medications vs. supplements

Alternative Treatments for Erectile Dysfunction

While Viagra and L-arginine are popular options for addressing erectile dysfunction, there are several other treatments available. It’s important to explore all options and consult with a healthcare provider to determine the most appropriate approach for individual needs.

Are there natural alternatives to Viagra for treating ED? Several natural remedies and lifestyle changes have been suggested to improve erectile function, including exercise, stress reduction, and certain herbal supplements. However, their effectiveness can vary, and scientific evidence is often limited compared to prescription medications.

Other Treatment Options for Erectile Dysfunction

• Other PDE5 inhibitors (e.g., Cialis, Levitra)
• Penile injections
• Vacuum erection devices
• Penile implants
• Psychological counseling

In conclusion, both Viagra and L-arginine have potential benefits for individuals with erectile dysfunction, but they differ significantly in their effectiveness, safety profiles, and mechanisms of action. Viagra remains the gold standard treatment for ED, with proven efficacy and well-understood side effects. L-arginine, while potentially beneficial for overall cardiovascular health, has less conclusive evidence for its effectiveness in treating ED.

It’s crucial for individuals considering either option to consult with a healthcare provider to determine the most appropriate treatment approach. This is particularly important when considering combining Viagra and L-arginine, as the interaction between these substances can potentially lead to increased side effects or complications.

Ultimately, the choice between Viagra, L-arginine, or other treatment options should be based on individual health status, the severity of ED, personal preferences, and medical advice. A comprehensive approach to addressing erectile dysfunction may include a combination of lifestyle changes, medical treatments, and psychological support to achieve optimal results and improve overall sexual health and well-being.

Health Benefits, Uses, Side Effects, Dosage & Interactions

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Boger, R. H., Sullivan, L. M., Schwedhelm, E., Wang, T. J., Maas, R., Benjamin, E. J., Schulze, F., Xanthakis, V., Benndorf, R. A., and Vasan, R. S. Plasma asymmetric dimethylarginine and incidence of cardiovascular disease and death in the community. Circulation 3-31-2009;119(12):1592-1600. View abstract.

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Chilosi, A., Leuzzi, V., Battini, R., Tosetti, M., Ferretti, G., Comparini, A., Casarano, M., Moretti, E., Alessandri, M. G., Bianchi, M. C., and Cioni, G. Treatment with L-arginine improves neuropsychological disorders in a child with creatine transporter defect. Neurocase. 2008;14(2):151-161. View abstract.

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De, Nicola L., Bellizzi, V., Minutolo, R., Andreucci, M., Capuano, A., Garibotto, G., Corso, G., Andreucci, V. E., and Cianciaruso, B. Randomized, double-blind, placebo-controlled study of arginine supplementation in chronic renal failure. Kidney Int. 1999;56(2):674-684. View abstract.

Debats, I. B., Booi, D. I., Wehrens, K. M., Cleutjens, J., Deutz, N. E., van de Hogen, E., Bemelmans, M., and van der Hulst, R. R. Oral arginine supplementation and the effect on skin graft donor sites: a randomized clinical pilot study. J Burn Care Res 2009;30(3):417-426. View abstract.

Dell’Omo, G., Catapano, G., Ebel, M., Gazzano, A., Ducci, M., Del, Chicca M., Clerico, A., and Pedrinelli, R. [Pressor, renal and endocrine effects of systemic infusion of L-arginine in hypertensive patients]. Ann.Ital Med.Int. 1995;10(2):107-112. View abstract.

Desneves, K. J., Todorovic, B. E., Cassar, A., and Crowe, T. C. Treatment with supplementary arginine, vitamin C and zinc in patients with pressure ulcers: a randomised controlled trial. Clin.Nutr. 2005;24(6):979-987. View abstract.

Di, Carlo, V, Gianotti, L., Balzano, G., Zerbi, A., and Braga, M. Complications of pancreatic surgery and the role of perioperative nutrition. Dig.Surg. 1999;16(4):320-326. View abstract.

Docimo, R., Montesani, L., Maturo, P., Costacurta, M., Bartolino, M., Zhang, Y. P., DeVizio, W., Delgado, E., Cummins, D., Dibart, S., and Mateo, L. R. Comparing the efficacy in reducing dentin hypersensitivity of a new toothpaste containing 8.0% arginine, calcium carbonate, and 1450 ppm fluoride to a benchmark commercial desensitizing toothpaste containing 2% potassium ion: an eight-week clinical study in Rome, Italy. J Clin.Dent. 2009;20(4):137-143. View abstract.

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Drover, J. W., Dhaliwal, R., Weitzel, L., Wischmeyer, P. E., Ochoa, J. B., and Heyland, D. K. Perioperative use of arginine-supplemented diets: a systematic review of the evidence. J Am.Coll.Surg. 2011;212(3):385-99, 399. View abstract.

Dudek, D., Legutko, J., Heba, G., Bartus, S., Partyka, L., Huk, I., Dembinska-Kiec, A., Kaluza, G. L., and Dubiel, J. S. L-arginine supplementation does not inhibit neointimal formation after coronary stenting in human beings: an intravascular ultrasound study. Am Heart J 2004;147(4):E12. View abstract.

Egashira, K., Hirooka, Y., Kuga, T., Mohri, M., and Takeshita, A. Effects of L-arginine supplementation on endothelium-dependent coronary vasodilation in patients with angina pectoris and normal coronary arteriograms. Circulation 7-15-1996;94(2):130-134. View abstract.

Elam, R. P., Hardin, D. H., Sutton, R. A., and Hagen, L. Effects of arginine and ornithine on strength, lean body mass and urinary hydroxyproline in adult males. J Sports Med.Phys.Fitness 1989;29(1):52-56. View abstract.

Ellinger, S. and Stehle, P. Efficacy of vitamin supplementation in situations with wound healing disorders: results from clinical intervention studies. Curr.Opin.Clin.Nutr.Metab Care 2009;12(6):588-595. View abstract.

Eshghi F. The efficacy of L-arginine gel for treatment of chronic anal fissure compared to surgical sphincterotomy. Journal of Medical Sciences. 2007;7(3):481-484.

Facchinetti, F., Longo, M., Piccinini, F., Neri, I., and Volpe, A. L-arginine infusion reduces blood pressure in preeclamptic women through nitric oxide release. J Soc Gynecol.Investig. 1999;6(4):202-207. View abstract.

Facchinetti, F., Saade, G. R., Neri, I., Pizzi, C., Longo, M., and Volpe, A. L-arginine supplementation in patients with gestational hypertension: a pilot study. Hypertens.Pregnancy. 2007;26(1):121-130. View abstract.

Fallon, E. M., Nehra, D., Potemkin, A. K., Gura, K. M., Simpser, E., Compher, C., and Puder, M. A.S.P.E.N. clinical guidelines: nutrition support of neonatal patients at risk for necrotizing enterocolitis. JPEN J Parenter.Enteral Nutr 2012;36(5):506-523. View abstract.

Fan, X. Y., van den Berg, A., Snoek, M., van der Flier, L. G., Smids, B., Jansen, H. M., Liu, R. Y., and Lutter, R. Arginine deficiency augments inflammatory mediator production by airway epithelial cells in vitro. Respir.Res 2009;10:62. View abstract.

Farreras, N., Artigas, V., Cardona, D., Rius, X., Trias, M., and Gonzalez, J. A. Effect of early postoperative enteral immunonutrition on wound healing in patients undergoing surgery for gastric cancer. Clin.Nutr 2005;24(1):55-65. View abstract.

Finco, C., Magnanini, P., Sarzo, G., Vecchiato, M., Luongo, B., Savastano, S., Bortoliero, M., Barison, P., and Merigliano, S. Prospective randomized study on perioperative enteral immunonutrition in laparoscopic colorectal surgery. Surg.Endosc. 2007;21(7):1175-1179. View abstract.

Fons, C., Sempere, A., Arias, A., Lopez-Sala, A., Poo, P., Pineda, M., Mas, A., Vilaseca, M. A., Salomons, G. S., Ribes, A., Artuch, R., and Campistol, J. Arginine supplementation in four patients with X-linked creatine transporter defect. J Inherit.Metab Dis 2008;31(6):724-728. View abstract.

Fricke, O., Baecker, N., Heer, M., Tutlewski, B., and Schoenau, E. The effect of L-arginine administration on muscle force and power in postmenopausal women. Clin.Physiol Funct.Imaging 2008;28(5):307-311. View abstract.

Furuno T, Mullen MJ Thorne SA Thomson H Donald AE Powe A et al. Intravenous L-arginine restores endothelial function in healthy young smokers (abstract). Circulation 1996;94:3052.

Gad, M. Z., El-Mesallamy, H. O., and Sanad, E. F. hsCRP, sICAM-1 and TAFI in hemodialysis patients: linking inflammation and hypofibrinolysis to cardiovascular events. Kidney Blood Press Res 2008;31(6):391-397. View abstract.

Garhofer, G., Resch, H., Lung, S., Weigert, G., and Schmetterer, L. Intravenous administration of L-arginine increases retinal and choroidal blood flow. Am J Ophthalmol. 2005;140(1):69-76. View abstract.

Gaston, R. S., Schlessinger, S. D., Sanders, P. W., Barker, C. V., Curtis, J. J., and Warnock, D. G. Cyclosporine inhibits the renal response to L-arginine in human kidney transplant recipients. J Am Soc Nephrol. 1995;5(7):1426-1433. View abstract.

Gentile, V., Antonini, G., Antonella, Bertozzi M., Dinelli, N., Rizzo, C., Ashraf, Virmani M., and Koverech, A. Effect of propionyl-L-carnitine, L-arginine and nicotinic acid on the efficacy of vardenafil in the treatment of erectile dysfunction in diabetes. Curr Med Res Opin. 2009;25(9):2223-2228. View abstract.

George, J., Shmuel, S. B., Roth, A., Herz, I., Izraelov, S., Deutsch, V., Keren, G., and Miller, H. L-arginine attenuates lymphocyte activation and anti-oxidized LDL antibody levels in patients undergoing angioplasty. Atherosclerosis 2004;174(2):323-327. View abstract.

Gianotti, L., Braga, M., Gentilini, O., Balzano, G., Zerbi, A., and Di, Carlo, V. Artificial nutrition after pancreaticoduodenectomy. Pancreas 2000;21(4):344-351. View abstract.

Gianotti, L., Braga, M., Nespoli, L., Radaelli, G., Beneduce, A., and Di, Carlo, V. A randomized controlled trial of preoperative oral supplementation with a specialized diet in patients with gastrointestinal cancer. Gastroenterology 2002;122(7):1763-1770. View abstract.

Gianotti, L., Braga, M., Vignali, A., Balzano, G., Zerbi, A., Bisagni, P., and Di, Carlo, V. Effect of route of delivery and formulation of postoperative nutritional support in patients undergoing major operations for malignant neoplasms. Arch.Surg. 1997;132(11):1222-1229. View abstract.

Giger, U., Buchler, M., Farhadi, J., Berger, D., Husler, J., Schneider, H., Krahenbuhl, S., and Krahenbuhl, L. Preoperative immunonutrition suppresses perioperative inflammatory response in patients with major abdominal surgery-a randomized controlled pilot study. Ann.Surg.Oncol. 2007;14(10):2798-2806. View abstract.

Giuggioli, D., Colaci, M., Sebastiani, M., and Ferri, C. L-Arginine in pregnant scleroderma patients. Clin.Rheumatol. 2010;29(8):937-939. View abstract.

Giugliano, D., Marfella, R., Coppola, L., Verrazzo, G., Acampora, R., Giunta, R., Nappo, F., Lucarelli, C., and D’Onofrio, F. Vascular effects of acute hyperglycemia in humans are reversed by L-arginine. Evidence for reduced availability of nitric oxide during hyperglycemia. Circulation 4-1-1997;95(7):1783-1790. View abstract.

Giugliano, D., Marfella, R., Verrazzo, G., Acampora, R., Coppola, L., Cozzolino, D., and D’Onofrio, F. The vascular effects of L-Arginine in humans. The role of endogenous insulin. J Clin.Invest 2-1-1997;99(3):433-438. View abstract.

Glueck, C. J., Munjal, J., Khan, A., Umar, M., and Wang, P. Endothelial nitric oxide synthase T-786C mutation, a reversible etiology of Prinzmetal’s angina pectoris. Am J Cardiol 3-15-2010;105(6):792-796. View abstract.

Goligorsky, M. S. Endothelial nitric oxide synthase: from structure to function in one aspartic substitution. Kidney Int. 2009;75(3):255-257. View abstract.

Gosselink, M. P., Darby, M., Zimmerman, D. D., Gruss, H. J., and Schouten, W. R. Treatment of chronic anal fissure by application of L-arginine gel: a phase II study in 15 patients. Dis Colon Rectum 2005;48(4):832-837. View abstract.

Grasemann, H., Grasemann, C., Kurtz, F., Tietze-Schillings, G., Vester, U., and Ratjen, F. Oral L-arginine supplementation in cystic fibrosis patients: a placebo-controlled study. Eur.Respir.J 2005;25(1):62-68. View abstract.

Gryglewski, R. J., Grodzinska, L., Kostka-Trabka, E., Korbut, R., Bieroon, K., Goszcz, A., and Slawinski, M. Treatment with L-arginine is likely to stimulate generation of nitric oxide in patients with peripheral arterial obstructive disease. Wien.Klin.Wochenschr. 1996;108(4):111-116. View abstract.

Guttman, H., Zimlichman, R., Boaz, M., Matas, Z., and Shargorodsky, M. Effect of Long-Term L-Arginine Supplementation on Arterial Compliance and Metabolic Parameters in Patients with Multiple Cardiovascular risk Factors: Randomized, Placebo-Controlled Study. J Cardiovasc.Pharmacol. 6-7-2010; View abstract.

Hackett, A., Gillard, J., and Wilcken, B. n of 1 trial for an ornithine transcarbamylase deficiency carrier. Mol.Genet.Metab 2008;94(2):157-161. View abstract.

Hayde, M., Vierhapper, H., Lubec, B., Popow, C., Weninger, M., Xi, Z., and Lubec, G. Low-dose dietary L-arginine increases plasma interleukin 1 alpha but not interleukin 1 beta in patients with diabetes mellitus. Cytokine 1994;6(1):79-82. View abstract.

Helminen, H., Raitanen, M., and Kellosalo, J. Immunonutrition in elective gastrointestinal surgery patients. Scand.J Surg. 2007;96(1):46-50. View abstract.

Herman, W. H., Fajans, S. S., Smith, M. J., Polonsky, K. S., Bell, G. I., and Halter, J. B. Diminished insulin and glucagon secretory responses to arginine in nondiabetic subjects with a mutation in the hepatocyte nuclear factor-4alpha/MODY1 gene. Diabetes 1997;46(11):1749-1754. View abstract.

Hertz, P. and Richardson, J. A. Arginine-induced hyperkalemia in renal failure patients. Arch.Intern.Med. 1972;130(5):778-780. View abstract.

Heyman, H., Van De Looverbosch, D. E., Meijer, E. P., and Schols, J. M. Benefits of an oral nutritional supplement on pressure ulcer healing in long-term care residents. J Wound Care 2008;17(11):476-8, 480. View abstract.

Heys, S. D., Ogston, K., Miller, I., Hutcheon, A. W., Walker, L. G., Sarker, T. K., Dewar, J., Ah-See, A. K., and Eremin, O. Potentiation of the response to chemotherapy in patients with breast cancer by dietary supplementation with L-arginine: results of a randomised controlled trial. Int.J Oncol. 1998;12(1):221-225. View abstract.

Higashi, Y., Oshima, T., Ono, N., Hiraga, H., Yoshimura, M., Watanabe, M., Matsuura, H., Kambe, M., and Kajiyama, G. Intravenous administration of L-arginine inhibits angiotensin-converting enzyme in humans. J Clin.Endocrinol.Metab 1995;80(7):2198-2202. View abstract.

Higashi, Y., Oshima, T., Ozono, R., Watanabe, M., Matsuura, H., and Kajiyama, G. Effects of L-arginine infusion on renal hemodynamics in patients with mild essential hypertension. Hypertension 1995;25(4 Pt 2):898-902. View abstract.

Hladunewich, M. A., Derby, G. C., Lafayette, R. A., Blouch, K. L., Druzin, M. L., and Myers, B. D. Effect of L-arginine therapy on the glomerular injury of preeclampsia: a randomized controlled trial. Obstet.Gynecol. 2006;107(4):886-895. View abstract.

Houwing, R. H., Rozendaal, M., Wouters-Wesseling, W., Beulens, J. W., Buskens, E., and Haalboom, J. R. A randomised, double-blind assessment of the effect of nutritional supplementation on the prevention of pressure ulcers in hip-fracture patients. Clin.Nutr. 2003;22(4):401-405. View abstract.

Hrncic, D., Rasic-Markovic, A., Krstic, D., Macut, D., Djuric, D., and Stanojlovic, O. The role of nitric oxide in homocysteine thiolactone-induced seizures in adult rats. Cell Mol.Neurobiol. 2010;30(2):219-231. View abstract.

Huang, C. C., Lin, T. J., Lu, Y. F., Chen, C. C., Huang, C. Y., and Lin, W. T. Protective effects of L-arginine supplementation against exhaustive exercise-induced oxidative stress in young rat tissues. Chin J Physiol 10-31-2009;52(5):306-315. View abstract.

Huang, C. C., Tsai, S. C., and Lin, W. T. Potential ergogenic effects of L-arginine against oxidative and inflammatory stress induced by acute exercise in aging rats. Exp.Gerontol. 2008;43(6):571-577. View abstract.

Hughes, N., Mason, S., Jeffery, P., Welton, H., Tobin, M., O’Shea, C., and Browne, M. A comparative clinical study investigating the efficacy of a test dentifrice containing 8% strontium acetate and 1040 ppm sodium fluoride versus a marketed control dentifrice containing 8% arginine, calcium carbonate, and 1450 ppm sodium monofluorophosphate in reducing dentinal hypersensitivity. J Clin.Dent. 2010;21(2):49-55. View abstract.

Jahangir, E., Vita, J. A., Handy, D., Holbrook, M., Palmisano, J., Beal, R., Loscalzo, J., and Eberhardt, R. T. The effect of L-arginine and creatine on vascular function and homocysteine metabolism. Vasc.Med. 2009;14(3):239-248. View abstract.

Jezova, D., Makatsori, A., Smriga, M., Morinaga, Y., and Duncko, R. Subchronic treatment with amino acid mixture of L-lysine and L-arginine modifies neuroendocrine activation during psychosocial stress in subjects with high trait anxiety. Nutr.Neurosci. 2005;8(3):155-160. View abstract.

Jiang, X. H., Li, N., Zhu, W. M., Wu, G. H., Quan, Z. W., and Li, J. S. Effects of postoperative immune-enhancing enteral nutrition on the immune system, inflammatory responses, and clinical outcome. Chin Med.J (Engl.) 2004;117(6):835-839. View abstract.

Jiang, Z. M., Gu, Z. Y., Chen, F. L., Wang, X. R., Li, Z. J., Xu, Y., and Li, R. [The role of immune enhanced enteral nutrition on plasma amino acid, gut permeability and clinical outcome (a randomized, double blind, controlled, multi-center clinical trail with 120 cases)]. Zhongguo Yi.Xue.Ke.Xue.Yuan Xue.Bao. 2001;23(5):515-518. View abstract.

Jovanovic, A., Gerrard, J., and Taylor, R. The second-meal phenomenon in type 2 diabetes. Diabetes Care 2009;32(7):1199-1201. View abstract.

Jude, E. B., Dang, C., and Boulton, A. J. Effect of L-arginine on the microcirculation in the neuropathic diabetic foot in Type 2 diabetes mellitus: a double-blind, placebo-controlled study. Diabet.Med. 2010;27(1):113-116. View abstract.

Kato, G. J. and Gladwin, M. T. Evolution of novel small-molecule therapeutics targeting sickle cell vasculopathy. JAMA 12-10-2008;300(22):2638-2646. View abstract.

Kato, G. J., Wang, Z., Machado, R. F., Blackwelder, W. C., Taylor, J. G., and Hazen, S. L. Endogenous nitric oxide synthase inhibitors in sickle cell disease: abnormal levels and correlations with pulmonary hypertension, desaturation, haemolysis, organ dysfunction and death. Br J Haematol. 2009;145(4):506-513. View abstract.

Kawano, H., Motoyama, T., Hirai, N., Kugiyama, K., Yasue, H., and Ogawa, H. Endothelial dysfunction in hypercholesterolemia is improved by L-arginine administration: possible role of oxidative stress. Atherosclerosis 2002;161(2):375-380. View abstract.

Kernohan, A. F., McIntyre, M., Hughes, D. M., Tam, S. W., Worcel, M., and Reid, J. L. An oral yohimbine/L-arginine combination (NMI 861) for the treatment of male erectile dysfunction: a pharmacokinetic, pharmacodynamic and interaction study with intravenous nitroglycerine in healthy male subjects. Br J Clin.Pharmacol. 2005;59(1):85-93. View abstract.

Khan, F. and Belch, J. J. Skin blood flow in patients with systemic sclerosis and Raynaud’s phenomenon: effects of oral L-arginine supplementation. J Rheumatol. 1999;26(11):2389-2394. View abstract.

Khan, F., Litchfield, S. J., McLaren, M., Veale, D. J., Littleford, R. C., and Belch, J. J. Oral L-arginine supplementation and cutaneous vascular responses in patients with primary Raynaud’s phenomenon. Arthritis Rheum. 1997;40(2):352-357. View abstract.

Kimber, J., Watson, L., and Mathias, C. J. Cardiovascular and neurohormonal responses to i. v. l-arginine in two groups with primary autonomic failure. J Neurol. 2001;248(12):1036-1041. View abstract.

Kirk, S. J., Hurson, M., Regan, M. C., Holt, D. R., Wasserkrug, H. L., and Barbul, A. Arginine stimulates wound healing and immune function in elderly human beings. Surgery 1993;114(2):155-159. View abstract.

Kiziltepe, U., Tunctan, B., Eyileten, Z. B., Sirlak, M., Arikbuku, M., Tasoz, R., Uysalel, A., and Ozyurda, U. Efficiency of L-arginine enriched cardioplegia and non-cardioplegic reperfusion in ischemic hearts. Int.J Cardiol 2004;97(1):93-100. View abstract.

Klek, S., Kulig, J., Sierzega, M., Szczepanek, K., Szybinski, P., Scislo, L., Walewska, E., Kubisz, A., and Szczepanik, A. M. Standard and immunomodulating enteral nutrition in patients after extended gastrointestinal surgery–a prospective, randomized, controlled clinical trial. Clin.Nutr 2008;27(4):504-512. View abstract.

Klek, S., Kulig, J., Sierzega, M., Szybinski, P., Szczepanek, K., Kubisz, A., Kowalczyk, T., Gach, T., Pach, R., and Szczepanik, A. M. The impact of immunostimulating nutrition on infectious complications after upper gastrointestinal surgery: a prospective, randomized, clinical trial. Ann.Surg. 2008;248(2):212-220. View abstract.

Knechtle, B. and Bosch, A. The influence of arginine supplementation on performance and metabolism in athletes. INTERNATIONAL SPORTMED JOURNAL 2008;9(1):22-31.

Kobayashi, N., Nakamura, M., and Hiramori, K. Effects of infusion of L-arginine on exercise-induced myocardial ischemic ST-segment changes and capacity to exercise of patients with stable angina pectoris. Coron.Artery Dis 1999;10(5):321-326. View abstract.

Koga, Y. [L-arginine therapy on MELAS]. Rinsho Shinkeigaku 2008;48(11):1010-1012. View abstract.

Koga, Y., Akita, Y., Junko, N., Yatsuga, S., Povalko, N., Fukiyama, R., Ishii, M., and Matsuishi, T. Endothelial dysfunction in MELAS improved by l-arginine supplementation. Neurology 6-13-2006;66(11):1766-1769. View abstract.

Koga, Y., Akita, Y., Nishioka, J., Yatsuga, S., Povalko, N., Tanabe, Y., Fujimoto, S., and Matsuishi, T. L-arginine improves the symptoms of strokelike episodes in MELAS. Neurology 2-22-2005;64(4):710-712. View abstract.

Koga, Y., Povalko, N., Nishioka, J., Katayama, K., Kakimoto, N., and Matsuishi, T. MELAS and L-arginine therapy: pathophysiology of stroke-like episodes. Ann.N.Y.Acad.Sci. 2010;1201:104-110. View abstract.

Koifman, B., Wollman, Y., Bogomolny, N., Chernichowsky, T., Finkelstein, A., Peer, G., Scherez, J., Blum, M., Laniado, S., Iaina, A., and . Improvement of cardiac performance by intravenous infusion of L-arginine in patients with moderate congestive heart failure. J Am Coll.Cardiol 11-1-1995;26(5):1251-1256. View abstract.

Koller-Strametz, J., Wolzt, M., Fuchs, C., Putz, D., Wisser, W., Mensik, C., Eichler, H. G., Laufer, G., and Schmetterer, L. Renal hemodynamic effects of L-arginine and sodium nitroprusside in heart transplant recipients. Kidney Int. 1999;55(5):1871-1877. View abstract.

Komers, R., Komersova, K., Kazdova, L., Ruzickova, J., and Pelikanova, T. Effect of ACE inhibition and angiotensin AT1 receptor blockade on renal and blood pressure response to L-arginine in humans. J Hypertens. 2000;18(1):51-59. View abstract.

Koppo, K., Taes, Y. E., Pottier, A., Boone, J., Bouckaert, J., and Derave, W. Dietary arginine supplementation speeds pulmonary VO2 kinetics during cycle exercise. Med.Sci.Sports Exerc. 2009;41(8):1626-1632. View abstract.

Lagudis, S., Yamada, A. T., Vieira, M. L., Medeiros, C. C., Mansur, A. J., and Lage, S. G. The effect of dobutamine without and with L-arginine on arterial compliance in heart failure patients. Echocardiography. 2009;26(8):934-942. View abstract.

Lakhan, S. E. and Vieira, K. F. Nutritional and herbal supplements for anxiety and anxiety-related disorders: systematic review. Nutr J 2010;9:42. View abstract.

Langkamp-Henken, B., Herrlinger-Garcia, K. A., Stechmiller, J. K., Nickerson-Troy, J. A., Lewis, B., and Moffatt, L. Arginine supplementation is well tolerated but does not enhance mitogen-induced lymphocyte proliferation in elderly nursing home residents with pressure ulcers. JPEN J Parenter.Enteral Nutr. 2000;24(5):280-287. View abstract.

Lauer, T., Kleinbongard, P., Rath, J., Schulz, R., Kelm, M., and Rassaf, T. L-arginine preferentially dilates stenotic segments of coronary arteries thereby increasing coronary flow. J Intern.Med. 2008;264(3):237-244. View abstract.

Ledda, A., Belcaro, G., Cesarone, M. R., Dugall, M., and Schonlau, F. Investigation of a complex plant extract for mild to moderate erectile dysfunction in a randomized, double-blind, placebo-controlled, parallel-arm study. BJU.Int. 2010;106(7):1030-1033. View abstract.

Lee, J., Ryu, H., and Kowall, N. W. Motor neuronal protection by L-arginine prolongs survival of mutant SOD1 (G93A) ALS mice. Biochem.Biophys.Res Commun. 7-10-2009;384(4):524-529. View abstract.

Lekakis, J. P., Papathanassiou, S., Papaioannou, T. G., Papamichael, C. M., Zakopoulos, N., Kotsis, V., Dagre, A. G., Stamatelopoulos, K., Protogerou, A., and Stamatelopoulos, S. F. Oral L-arginine improves endothelial dysfunction in patients with essential hypertension. Int.J Cardiol 2002;86(2-3):317-323. View abstract.

Little, J. A., Hauser, K. P., Martyr, S. E., Harris, A., Maric, I., Morris, C. R., Suh, J. H., Taylor, J., Castro, O., Machado, R., Kato, G., and Gladwin, M. T. Hematologic, biochemical, and cardiopulmonary effects of L-arginine supplementation or phosphodiesterase 5 inhibition in patients with sickle cell disease who are on hydroxyurea therapy. Eur.J Haematol. 2009;82(4):315-321. View abstract.

Lobo, D. N., Williams, R. N., Welch, N. T., Aloysius, M. M., Nunes, Q. M., Padmanabhan, J., Crowe, J. R., Iftikhar, S. Y., Parsons, S. L., Neal, K. R., Allison, S. P., and Rowlands, B. J. Early postoperative jejunostomy feeding with an immune modulating diet in patients undergoing resectional surgery for upper gastrointestinal cancer: a prospective, randomized, controlled, double-blind study. Clin.Nutr 2006;25(5):716-726. View abstract.

Lubec, B., Hayn, M., Kitzmuller, E., Vierhapper, H., and Lubec, G. L-Arginine reduces lipid peroxidation in patients with diabetes mellitus. Free Radic.Biol.Med. 1997;22(1-2):355-357. View abstract.

Lucotti, P., Monti, L., Setola, E., La, Canna G., Castiglioni, A., Rossodivita, A., Pala, M. G., Formica, F., Paolini, G., Catapano, A. L., Bosi, E., Alfieri, O., and Piatti, P. Oral L-arginine supplementation improves endothelial function and ameliorates insulin sensitivity and inflammation in cardiopathic nondiabetic patients after an aortocoronary bypass. Metabolism 2009;58(9):1270-1276. View abstract.

Lucotti, P., Setola, E., Monti, L. D., Galluccio, E., Costa, S., Sandoli, E. P., Fermo, I., Rabaiotti, G., Gatti, R., and Piatti, P. Beneficial effects of a long-term oral L-arginine treatment added to a hypocaloric diet and exercise training program in obese, insulin-resistant type 2 diabetic patients. Am J Physiol Endocrinol.Metab 2006;291(5):E906-E912. View abstract.

Malenfant, D., Catton, M., and Pope, J. E. The efficacy of complementary and alternative medicine in the treatment of Raynaud’s phenomenon: a literature review and meta-analysis. Rheumatology.(Oxford) 2009;48(7):791-795. View abstract.

Mansoor, J. K., Morrissey, B. M., Walby, W. F., Yoneda, K. Y., Juarez, M., Kajekar, R., Severinghaus, J. W., Eldridge, M. W., and Schelegle, E. S. L-arginine supplementation enhances exhaled NO, breath condensate VEGF, and headache at 4,342 m. High Alt.Med.Biol. 2005;6(4):289-300. View abstract.

Mantovani, F., Patelli, E., Colombo, F., Pozzoni, F., Confalonieri, S., and Pisani, E. [Erectile dysfunction after non-nerve sparing radical pelvic surgery. Therapeutical experience with sildenafil and L-arginine evaluated by Buckling test]. Minerva Med. 2001;92(4):285-287. View abstract.

Marfella, R., Acampora, R., Verrazzo, G., Ziccardi, P., De, Rosa N., Giunta, R., and Giugliano, D. Metformin improves hemodynamic and rheological responses to L-arginine in NIDDM patients. Diabetes Care 1996;19(9):934-939. View abstract.

Marietta, M., Facchinetti, F., Neri, I., Piccinini, F., Volpe, A., and Torelli, G. L-arginine infusion decreases platelet aggregation through an intraplatelet nitric oxide release. Thromb.Res 10-15-1997;88(2):229-235. View abstract.

Marik, P. E. and Zaloga, G. P. Immunonutrition in critically ill patients: a systematic review and analysis of the literature. Intensive Care Med. 2008;34(11):1980-1990. View abstract.

Marik, P. E. and Zaloga, G. P. Immunonutrition in high-risk surgical patients: a systematic review and analysis of the literature. JPEN J Parenter.Enteral Nutr 2010;34(4):378-386. View abstract.

Marin, V. B., Rodriguez-Osiac, L., Schlessinger, L., Villegas, J., Lopez, M., and Castillo-Duran, C. Controlled study of enteral arginine supplementation in burned children: impact on immunologic and metabolic status. Nutrition 2006;22(7-8):705-712. View abstract.

Marti-Carvajal, A. J., Knight-Madden, J. M., and Martinez-Zapata, M. J. Interventions for treating leg ulcers in people with sickle cell disease. Cochrane.Database.Syst.Rev. 2012;11:CD008394. View abstract.

Martina, V., Masha, A., Gigliardi, V. R., Brocato, L., Manzato, E., Berchio, A., Massarenti, P., Settanni, F., Della, Casa L., Bergamini, S., and Iannone, A. Long-term N-acetylcysteine and L-arginine administration reduces endothelial activation and systolic blood pressure in hypertensive patients with type 2 diabetes. Diabetes Care 2008;31(5):940-944. View abstract.

Masha, A., Manieri, C., Dinatale, S., Bruno, G. A., Ghigo, E., and Martina, V. Prolonged treatment with N-acetylcysteine and L-arginine restores gonadal function in patients with polycystic ovary syndrome. J Endocrinol.Invest 2009;32(11):870-872. View abstract.

Matsumoto, K., Mizuno, M., Mizuno, T., Dilling-Hansen, B., Lahoz, A., Bertelsen, V., Munster, H., Jordening, H., Hamada, K., and Doi, T. Branched-chain amino acids and arginine supplementation attenuates skeletal muscle proteolysis induced by moderate exercise in young individuals. Int.J Sports Med. 2007;28(6):531-538. View abstract.

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Maxwell, A. J., Anderson, B. E., and Cooke, J. P. Nutritional therapy for peripheral arterial disease: a double-blind, placebo-controlled, randomized trial of HeartBar. Vasc.Med. 2000;5(1):11-19. View abstract.

McCarter, M. D., Gentilini, O. D., Gomez, M. E., and Daly, J. M. Preoperative oral supplement with immunonutrients in cancer patients. JPEN J Parenter.Enteral Nutr 1998;22(4):206-211. View abstract.

McConell, G. K. Effects of L-arginine supplementation on exercise metabolism. Curr.Opin.Clin.Nutr.Metab Care 2007;10(1):46-51. View abstract.

McGovern, M. M., Wasserstein, M. P., Aron, A., and Perrine, S. P. Biochemical effect of intravenous arginine butyrate in X-linked adrenoleukodystrophy. J Pediatr 2003;142(6):709-713. View abstract.

McMahon, L., Tamary, H., Askin, M., Adams-Graves, P., Eberhardt, R. T., Sutton, M., Wright, E. C., Castaneda, S. A., Faller, D. V., and Perrine, S. P. A randomized phase II trial of Arginine Butyrate with standard local therapy in refractory sickle cell leg ulcers. Br.J Haematol. 2010;151(5):516-524. View abstract.

Mehta, S., Stewart, D. J., and Levy, R. D. The hypotensive effect of L-arginine is associated with increased expired nitric oxide in humans. Chest 1996;109(6):1550-1555. View abstract.

Mehta, S., Stewart, D. J., Langleben, D., and Levy, R. D. Short-term pulmonary vasodilation with L-arginine in pulmonary hypertension. Circulation 9-15-1995;92(6):1539-1545. View abstract.

Mhanni, A. A., Chan, A., Collison, M., Seifert, B., Lehotay, D. C., Sokoro, A., Huynh, H. Q., and Greenberg, C. R. Hyperornithinemia-hyperammonemia-homocitrullinuria syndrome (HHH) presenting with acute fulminant hepatic failure. J Pediatr Gastroenterol.Nutr. 2008;46(3):312-315. View abstract.

Miller, H. I., Dascalu, A., Rassin, T. A., Wollman, Y., Chernichowsky, T., and Iaina, A. Effects of an acute dose of L-arginine during coronary angiography in patients with chronic renal failure: a randomized, parallel, double-blind clinical trial. Am J Nephrol. 2003;23(2):91-95. View abstract.

Miroueh, A. Effect of arginine on oligospermia. Fertil.Steril. 1970;21(3):217-219. View abstract.

Morgante, G., Scolaro, V., Tosti, C., Di, Sabatino A., Piomboni, P., and De, Leo, V. [Treatment with carnitine, acetyl carnitine, L-arginine and ginseng improves sperm motility and sexual health in men with asthenopermia]. Minerva Urol.Nefrol. 2010;62(3):213-218. View abstract.

Morris, C. R., Kuypers, F. A., Larkin, S., Sweeters, N., Simon, J., Vichinsky, E. P., and Styles, L. A. Arginine therapy: a novel strategy to induce nitric oxide production in sickle cell disease. Br J Haematol. 2000;111(2):498-500. View abstract.

Mou, J., Fang, H., Jing, F., Wang, Q., Liu, Y., Zhu, H., Shang, L., Wang, X., and Xu, W. Design, synthesis and primary activity evaluation of L-arginine derivatives as amino-peptidase N/CD13 inhibitors. Bioorg.Med.Chem. 7-1-2009;17(13):4666-4673. View abstract.

Moutaouakil, F., El, Otmani H., Fadel, H., Sefrioui, F., and Slassi, I. [l-arginine efficiency in MELAS syndrome. A case report]. Rev.Neurol.(Paris) 2009;165(5):482-485. View abstract.

Nagaya, N., Uematsu, M., Oya, H., Sato, N., Sakamaki, F., Kyotani, S., Ueno, K., Nakanishi, N., Yamagishi, M., and Miyatake, K. Short-term oral administration of L-arginine improves hemodynamics and exercise capacity in patients with precapillary pulmonary hypertension. Am J Respir.Crit Care Med. 2001;163(4):887-891. View abstract.

Napoli, C., Farzati, B., Sica, V., Iannuzzi, E., Coppola, G., Silvestroni, A., Balestrieri, M. L., Florio, A., and Matarazzo, A. Beneficial effects of autologous bone marrow cell infusion and antioxidants/L-arginine in patients with chronic critical limb ischemia. Eur.J Cardiovasc.Prev.Rehabil. 2008;15(6):709-718. View abstract.

Nathoo, S., Delgado, E., Zhang, Y. P., DeVizio, W., Cummins, D., and Mateo, L. R. Comparing the efficacy in providing instant relief of dentin hypersensitivity of a new toothpaste containing 8.0% arginine, calcium carbonate, and 1450 ppm fluoride relative to a benchmark desensitizing toothpaste containing 2% potassium ion and 1450 ppm fluoride, and to a control toothpaste with 1450 ppm fluoride: a three-day clinical study in New Jersey, USA. J Clin.Dent. 2009;20(4):123-130. View abstract.

Nelson, R. L., Thomas, K., Morgan, J., and Jones, A. Non surgical therapy for anal fissure. Cochrane.Database.Syst.Rev. 2012;2:CD003431. View abstract.

Neri, I., Blasi, I., and Facchinetti, F. Effects of acute L-arginine infusion on non-stress test in hypertensive pregnant women. J Matern.Fetal Neonatal Med. 2004;16(1):23-26. View abstract.

Neri, I., Jasonni, V. M., Gori, G. F., Blasi, I., and Facchinetti, F. Effect of L-arginine on blood pressure in pregnancy-induced hypertension: a randomized placebo-controlled trial. J Matern.Fetal Neonatal Med. 2006;19(5):277-281. View abstract.

Neri, I., Monari, F., Sgarbi, L., Berardi, A., Masellis, G., and Facchinetti, F. L-arginine supplementation in women with chronic hypertension: impact on blood pressure and maternal and neonatal complications. J Matern.Fetal Neonatal Med. 2010;23(12):1456-1460. View abstract.

Nitenberg, A., Ledoux, S., Attali, J. R., and Valensi, P. [Response of the coronary arteries to cold test and flow velocity increase is improved by deferoxamine but not by L-arginine in diabetic patients]. Arch.Mal Coeur Vaiss. 1997;90(8):1037-1041. View abstract.

O’Rourke, D. J., Ryan, S., Salomons, G., Jakobs, C., Monavari, A., and King, M. D. Guanidinoacetate methyltransferase (GAMT) deficiency: late onset of movement disorder and preserved expressive language. Dev.Med.Child Neurol. 2009;51(5):404-407. View abstract.

Oka, R. K., Szuba, A., Giacomini, J. C., and Cooke, J. P. A pilot study of L-arginine supplementation on functional capacity in peripheral arterial disease. Vasc.Med. 2005;10(4):265-274. View abstract.

Okamoto, Y., Okano, K., Izuishi, K., Usuki, H., Wakabayashi, H., and Suzuki, Y. Attenuation of the systemic inflammatory response and infectious complications after gastrectomy with preoperative oral arginine and omega-3 fatty acids supplemented immunonutrition. World J Surg. 2009;33(9):1815-1821. View abstract.

Olek, R. A., Ziemann, E., Grzywacz, T., Kujach, S., Luszczyk, M., Antosiewicz, J., and Laskowski, R. A single oral intake of arginine does not affect performance during repeated Wingate anaerobic test. J Sports Med.Phys.Fitness 2010;50(1):52-56. View abstract.

Ozbek, M., Erdogan, M., Karadeniz, M., Cetinkalp, S., Ozgen, A. G., Saygili, F., Yilmaz, C., and Tuzun, M. Evaluation of beta cell dysfunction by mixed meal tolerance test and oral L-arginine in patients with newly diagnosed type 2 diabetes mellitus. Exp.Clin.Endocrinol.Diabetes 2009;117(10):573-576. View abstract.

Palloshi, A., Fragasso, G., Piatti, P., Monti, L. D., Setola, E., Valsecchi, G., Galluccio, E., Chierchia, S. L., and Margonato, A. Effect of oral L-arginine on blood pressure and symptoms and endothelial function in patients with systemic hypertension, positive exercise tests, and normal coronary arteries. Am J Cardiol 4-1-2004;93(7):933-935. View abstract.

Park, K. G., Heys, S. D., Blessing, K., Kelly, P., McNurlan, M. A., Eremin, O., and Garlick, P. J. Stimulation of human breast cancers by dietary L-arginine. Clin.Sci.(Lond) 1992;82(4):413-417. View abstract.

Parnell, M. M., Holst, D. P., and Kaye, D. M. Augmentation of endothelial function following exercise training is associated with increased L-arginine transport in human heart failure. Clin.Sci.(Lond) 2005;109(6):523-530. View abstract.

Pedrinelli, R., Ebel, M., Catapano, G., Dell’Omo, G., Ducci, M., Del, Chicca M., and Clerico, A. Pressor, renal and endocrine effects of L-arginine in essential hypertensives. Eur.J Clin.Pharmacol. 1995;48(3-4):195-201. View abstract.

Petrou, I., Heu, R., Stranick, M., Lavender, S., Zaidel, L., Cummins, D., Sullivan, R. J., Hsueh, C., and Gimzewski, J. K. A breakthrough therapy for dentin hypersensitivity: how dental products containing 8% arginine and calcium carbonate work to deliver effective relief of sensitive teeth. J Clin.Dent. 2009;20(1):23-31. View abstract.

Pezza, V., Bernardini, F., Pezza, E., Pezza, B., and Curione, M. Study of supplemental oral l-arginine in hypertensives treated with enalapril + hydrochlorothiazide. Am.J Hypertens. 1998;11(10):1267-1270. View abstract.

Piatti, P. M., Monti, L. D., Valsecchi, G., Magni, F., Setola, E., Marchesi, F., Galli-Kienle, M., Pozza, G., and Alberti, K. G. Long-term oral L-arginine administration improves peripheral and hepatic insulin sensitivity in type 2 diabetic patients. Diabetes Care 2001;24(5):875-880. View abstract.

Pryor, J. P., Blandy, J. P., Evans, P., Chaput De Saintonge, D. M., and Usherwood, M. Controlled clinical trial of arginine for infertile men with oligozoospermia. Br J Urol. 1978;50(1):47-50. View abstract.

Puiman, P. J., Stoll, B., van Goudoever, J. B., and Burrin, D. G. Enteral arginine does not increase superior mesenteric arterial blood flow but induces mucosal growth in neonatal pigs. J Nutr. 2011;141(1):63-70. View abstract.

Quyyumi, A. A. Does acute improvement of endothelial dysfunction in coronary artery disease improve myocardial ischemia? A double-blind comparison of parenteral D- and L-arginine. J Am Coll.Cardiol 1998;32(4):904-911. View abstract.

Riso, S., Aluffi, P., Brugnani, M., Farinetti, F., Pia, F., and D’Andrea, F. Postoperative enteral immunonutrition in head and neck cancer patients. Clin.Nutr 2000;19(6):407-412. View abstract.

Ruel, M., Beanlands, R. S., Lortie, M., Chan, V., Camack, N., deKemp, R. A., Suuronen, E. J., Rubens, F. D., DaSilva, J. N., Sellke, F. W., Stewart, D. J., and Mesana, T. G. Concomitant treatment with oral L-arginine improves the efficacy of surgical angiogenesis in patients with severe diffuse coronary artery disease: the Endothelial Modulation in Angiogenic Therapy randomized controlled trial. J Thorac.Cardiovasc.Surg. 2008;135(4):762-70, 770. View abstract.

Rytlewski, K., Olszanecki, R., Korbut, R., and Zdebski, Z. Effects of prolonged oral supplementation with l-arginine on blood pressure and nitric oxide synthesis in preeclampsia. Eur.J Clin.Invest 2005;35(1):32-37. View abstract.

Rytlewski, K., Olszanecki, R., Lauterbach, R., Grzyb, A., and Basta, A. Effects of oral L-arginine on the foetal condition and neonatal outcome in preeclampsia: a preliminary report. Basic Clin.Pharmacol.Toxicol. 2006;99(2):146-152. View abstract.

Sakurai, Y., Masui, T., Yoshida, I., Tonomura, S., Shoji, M., Nakamura, Y., Isogaki, J., Uyama, I., Komori, Y., and Ochiai, M. Randomized clinical trial of the effects of perioperative use of immune-enhancing enteral formula on metabolic and immunological status in patients undergoing esophagectomy. World J Surg. 2007;31(11):2150-2157. View abstract.

Saleh, A. I., Abdel Maksoud, S. M., El-Maraghy, S. A., and Gad, M. Z. Protective effect of L-arginine in experimentally induced myocardial ischemia: comparison with aspirin. J Cardiovasc.Pharmacol.Ther 2011;16(1):53-62. View abstract.

Savoye, G., Jemaa, Y., Mosni, G., Savoye-Collet, C., Morcamp, P., Dechelotte, P., Bouin, M., Denis, P., and Ducrotte, P. Effects of intragastric L-arginine administration on proximal stomach tone under basal conditions and after an intragastric diet. Dig.Dis Sci. 2006;51(12):2147-2153. View abstract.

Sax, H. C. Arginine stimulates wound healing and immune function in elderly human beings. JPEN J Parenter.Enteral Nutr. 1994;18(6):559-560. View abstract.

Scavella, A., Leiva, L., Monjure, H., Zea, A. H., and Gardner, R. V. Effect of L-arginine supplementation on immune responsiveness in patients with sickle cell disease. Pediatr Blood Cancer 2010;55(2):318-323. View abstract.

Schachter, A., Friedman, S., Goldman, J. A., and Eckerling, B. Treatment of oligospermia with the amino acid arginine. Int.J Gynaecol.Obstet. 1973;11(5):206-209. View abstract.

Schachter, A., Goldman, J. A., and Zukerman, Z. Treatment of oligospermia with the amino acid arginine. J Urol. 1973;110(3):311-313. View abstract.

Schaefer, A., Piquard, F., Geny, B., Doutreleau, S., Lampert, E., Mettauer, B., and Lonsdorfer, J. L-arginine reduces exercise-induced increase in plasma lactate and ammonia. Int.J Sports Med. 2002;23(6):403-407. View abstract.

Schellong, S. M., Boger, R. H., Burchert, W., Bode-Boger, S. M., Galland, A., Frolich, J. C., Hundeshagen, H., and Alexander, K. Dose-related effect of intravenous L-arginine on muscular blood flow of the calf in patients with peripheral vascular disease: a h315O positron emission tomography study. Clin.Sci.(Lond) 1997;93(2):159-165. View abstract.

Schilling, J., Vranjes, N., Fierz, W., Joller, H., Gyurech, D., Ludwig, E., Marathias, K., and Geroulanos, S. Clinical outcome and immunology of postoperative arginine, omega-3 fatty acids, and nucleotide-enriched enteral feeding: a randomized prospective comparison with standard enteral and low calorie/low fat i.v. solutions. Nutrition 1996;12(6):423-429. View abstract.

Schlaich, M. P., Ahlers, B. A., Parnell, M. M., and Kaye, D. M. beta-Adrenoceptor-mediated, nitric-oxide-dependent vasodilatation is abnormal in early hypertension: restoration by L-arginine. J Hypertens. 2004;22(10):1917-1925. View abstract.

Schlaich, M. P., Jacobi, J., John, S., Delles, C., Fleischmann, I., and Schmieder, R. E. Is l-arginine infusion an adequate tool to assess endothelium-dependent vasodilation of the human renal vasculature? Clin.Sci.(Lond) 2000;99(4):293-302. View abstract.

Schlaich, M. P., Oehmer, S., Schneider, M. P., Delles, C., Schmidt, B. M., and Schmieder, R. E. Effects of nitric oxide synthase inhibition and L-arginine on renal haemodynamics in young patients at high cardiovascular risk. Atherosclerosis 2007;192(1):155-160. View abstract.

Schramm, L., La, M., Heidbreder, E., Hecker, M., Beckman, J. S., Lopau, K., Zimmermann, J., Rendl, J., Reiners, C., Winderl, S., Wanner, C., and Schmidt, H. H. L-arginine deficiency and supplementation in experimental acute renal failure and in human kidney transplantation. Kidney Int. 2002;61(4):1423-1432. View abstract.

Schulze, F., Glos, S., Petruschka, D., Altenburg, C., Maas, R., Benndorf, R., Schwedhelm, E., Beil, U., and Boger, R. H. L-Arginine enhances the triglyceride-lowering effect of simvastatin in patients with elevated plasma triglycerides. Nutr.Res 2009;29(5):291-297. View abstract.

Scibona, M., Meschini, P., Capparelli, S., Pecori, C., Rossi, P., and Menchini Fabris, G. F. [L-arginine and male infertility]. Minerva Urol.Nefrol. 1994;46(4):251-253. View abstract.

Senkal, M., Mumme, A., Eickhoff, U., Geier, B., Spath, G., Wulfert, D., Joosten, U., Frei, A., and Kemen, M. Early postoperative enteral immunonutrition: clinical outcome and cost-comparison analysis in surgical patients. Crit Care Med. 1997;25(9):1489-1496. View abstract.

Senkal, M., Zumtobel, V., Bauer, K. H., Marpe, B., Wolfram, G., Frei, A., Eickhoff, U., and Kemen, M. Outcome and cost-effectiveness of perioperative enteral immunonutrition in patients undergoing elective upper gastrointestinal tract surgery: a prospective randomized study. Arch.Surg. 1999;134(12):1309-1316. View abstract.

Settergren, M., Bohm, F., Malmstrom, R. E., Channon, K. M., and Pernow, J. L-arginine and tetrahydrobiopterin protects against ischemia/reperfusion-induced endothelial dysfunction in patients with type 2 diabetes mellitus and coronary artery disease. Atherosclerosis 2009;204(1):73-78. View abstract.

Shao, A. and Hathcock, J. N. Risk assessment for the amino acids taurine, L-glutamine and L-arginine. Regul.Toxicol.Pharmacol 2008;50(3):376-399. View abstract.

Shigemi, R., Fukuda, M., Suzuki, Y., Morimoto, T., and Ishii, E. L-arginine is effective in stroke-like episodes of MELAS associated with the G13513A mutation. Brain Dev. 2011;33(6):518-520. View abstract.

Siasos, G., Tousoulis, D., Vlachopoulos, C., Antoniades, C., Stefanadi, E., Ioakeimidis, N., Andreou, I., Zisimos, K., Papavassiliou, A. G., and Stefanadis, C. Short-term treatment with L-arginine prevents the smoking-induced impairment of endothelial function and vascular elastic properties in young individuals. Int.J Cardiol 6-6-2008;126(3):394-399. View abstract.

Sieroszewski, P., Suzin, J., and Karowicz-Bilinska, A. Ultrasound evaluation of intrauterine growth restriction therapy by a nitric oxide donor (L-arginine). J Matern.Fetal Neonatal Med. 2004;15(6):363-366. View abstract.

Slawinski, M., Grodzinska, L., Kostka-Trabka, E., Bieron, K., Goszcz, A., and Gryglewski, R. J. L-arginine–substrate for no synthesis–its beneficial effects in therapy of patients with peripheral arterial disease: comparison with placebo-preliminary results. Acta Physiol Hung. 1996;84(4):457-458. View abstract.

Smith, S. D., Wheeler, M. A., Foster, H. E., Jr., and Weiss, R. M. Improvement in interstitial cystitis symptom scores during treatment with oral L-arginine. J Urol. 1997;158(3 Pt 1):703-708. View abstract.

Smriga, M., Ando, T., Akutsu, M., Furukawa, Y., Miwa, K., and Morinaga, Y. Oral treatment with L-lysine and L-arginine reduces anxiety and basal cortisol levels in healthy humans. Biomed.Res 2007;28(2):85-90. View abstract.

Smulders, R. A., Aarsen, M., Teerlink, T., De Vries, P. M., Van Kamp, G. J., Donker, A. J., and Stehouwer, C. D. Haemodynamic and biochemical responses to L-arginine and L-lysine infusions in normal subjects: L-arginine-induced vasodilatation cannot be explained by non-specific effects of cationic amino acids. Clin.Sci.(Lond) 1997;92(4):367-374. View abstract.

Smulders, R. A., Stehouwer, C. D., Olthof, C. G., Van Kamp, G. J., Teerlink, T., De Vries, P. M., and Donker, A. J. Plasma endothelin levels and vascular effects of intravenous L-arginine infusion in subjects with uncomplicated insulin-dependent diabetes mellitus. Clin.Sci (Lond) 1994;87(1):37-43. View abstract.

Snyderman, C. H., Kachman, K., Molseed, L., Wagner, R., D’Amico, F., Bumpous, J., and Rueger, R. Reduced postoperative infections with an immune-enhancing nutritional supplement. Laryngoscope 1999;109(6):915-921. View abstract.

Song, J. X., Qing, S. H., Huang, X. C., and Qi, D. L. Effect of parenteral nutrition with L-arginine supplementation on postoperative immune function in patients with colorectal cancer. Di Yi.Jun.Yi.Da.Xue.Xue.Bao. 2002;22(6):545-547. View abstract.

Sozykin, A. V., Noeva, E. A., Balakhonova, T. V., Pogorelova, O. A., and Men’shikov, M. I. [Effect of L-arginine on platelet aggregation, endothelial function adn exercise tolerance in patients with stable angina pectoris]. Ter.Arkh. 2000;72(8):24-27. View abstract.

Srivastava, S. and Agarwal, A. Effect of anion channel blockers on L-arginine action in spermatozoa from asthenospermic men. Andrologia 2010;42(2):76-82. View abstract.

Stanislavov, R., Nikolova, V., and Rohdewald, P. Improvement of seminal parameters with Prelox: a randomized, double-blind, placebo-controlled, cross-over trial. Phytother.Res 2009;23(3):297-302. View abstract.

Stechmiller, J. K. Understanding the role of nutrition and wound healing. Nutr.Clin.Pract. 2010;25(1):61-68. View abstract.

Stechmiller, J. K., Langkamp-Henken, B., Childress, B., Herrlinger-Garcia, K. A., Hudgens, J., Tian, L., Percival, S. S., and Steele, R. Arginine supplementation does not enhance serum nitric oxide levels in elderly nursing home residents with pressure ulcers. Biol.Res Nurs. 2005;6(4):289-299. View abstract.

Stokes, G. S., Barin, E. S., Gilfillan, K. L., and Kaesemeyer, W. H. Interactions of L-arginine, isosorbide mononitrate, and angiotensin II inhibitors on arterial pulse wave. Am J Hypertens. 2003;16(9 Pt 1):719-724. View abstract.

Sullivan, K. J., Kissoon, N., Sandler, E., Gauger, C., Froyen, M., Duckworth, L., Brown, M., and Murphy, S. Effect of oral arginine supplementation on exhaled nitric oxide concentration in sickle cell anemia and acute chest syndrome. J Pediatr Hematol.Oncol. 2010;32(7):e249-e258. View abstract.

Sun, T., Zhou, W. B., Luo, X. P., Tang, Y. L., and Shi, H. M. Oral L-arginine supplementation in acute myocardial infarction therapy: a meta-analysis of randomized controlled trials. Clin.Cardiol 2009;32(11):649-652. View abstract.

Sunderland, K. L., Greer, F., and Morales, J. VO2max and ventilatory threshold of trained cyclists are not affected by 28-day L-arginine supplementation. J Strength.Cond.Res 2011;25(3):833-837. View abstract.

Suzuki, T., Hayase, M., Hibi, K., Hosokawa, H., Yokoya, K., Fitzgerald, P. J., Yock, P. G., Cooke, J. P., Suzuki, T., and Yeung, A. C. Effect of local delivery of L-arginine on in-stent restenosis in humans. Am J Cardiol 2-15-2002;89(4):363-367. View abstract.

Sydow, K., Schwedhelm, E., Arakawa, N., Bode-Boger, S. M., Tsikas, D., Hornig, B., Frolich, J. C., and Boger, R. H. ADMA and oxidative stress are responsible for endothelial dysfunction in hyperhomocyst(e)inemia: effects of L-arginine and B vitamins. Cardiovasc.Res 2003;57(1):244-252. View abstract.

Takasaki, A., Tamura, H., Miwa, I., Taketani, T., Shimamura, K., and Sugino, N. Endometrial growth and uterine blood flow: a pilot study for improving endometrial thickness in the patients with a thin endometrium. Fertil.Steril. 2010;93(6):1851-1858. View abstract.

Tan, B., Yin, Y., Liu, Z., Tang, W., Xu, H., Kong, X., Li, X., Yao, K., Gu, W., Smith, S. B., and Wu, G. Dietary L-arginine supplementation differentially regulates expression of lipid-metabolic genes in porcine adipose tissue and skeletal muscle. J Nutr.Biochem. 2011;22(5):441-445. View abstract.

Tangphao, O., Grossmann, M., Chalon, S., Hoffman, B. B., and Blaschke, T. F. Pharmacokinetics of intravenous and oral L-arginine in normal volunteers. Br J Clin.Pharmacol. 1999;47(3):261-266. View abstract.

Tanimura, J. Studies on arginine in human semen. I. The arginine contents of normal and sterile human semen. Bull.Osaka Med.Sch 1967;13(2):76-83. View abstract.

Tanimura, J. Studies on arginine in human semen. II. The effects of medication with L-arginine-HCL on male infertility. Bull.Osaka Med.Sch 1967;13(2):84-89. View abstract.

Tarumoto, T., Imagawa, S., Kobayashi, M., Hirayama, A., Ozawa, K., and Nagasawa, T. L-arginine administration reverses anemia associated with renal disease. Int.J Hematol. 2007;86(2):126-129. View abstract.

Tepaske, R., te, Velthuis H., Oudemans-van Straaten, H. M., Bossuyt, P. M., Schultz, M. J., Eijsman, L., and Vroom, M. Glycine does not add to the beneficial effects of perioperative oral immune-enhancing nutrition supplements in high-risk cardiac surgery patients. JPEN J Parenter.Enteral Nutr 2007;31(3):173-180. View abstract.

Theilmeier, G., Chan, J. R., Zalpour, C., Anderson, B., Wang, B. Y., Wolf, A., Tsao, P. S., and Cooke, J. P. Adhesiveness of mononuclear cells in hypercholesterolemic humans is normalized by dietary L-arginine. Arterioscler.Thromb.Vasc.Biol. 1997;17(12):3557-3564. View abstract.

Thorne, S., Mullen, M. J., Clarkson, P., Donald, A. E., and Deanfield, J. E. Early endothelial dysfunction in adults at risk from atherosclerosis: different responses to L-arginine. J Am.Coll.Cardiol. 1998;32(1):110-116. View abstract.

Tripathi, P. and Misra, M. K. Therapeutic role of L-arginine on free radical scavenging system in ischemic heart diseases. Indian J Biochem.Biophys. 2009;46(6):498-502. View abstract.

Tripathi, P., Chandra, M., and Misra, M. K. Oral administration of L-arginine in patients with angina or following myocardial infarction may be protective by increasing plasma superoxide dismutase and total thiols with reduction in serum cholesterol and xanthine oxidase. Oxid.Med.Cell Longev. 2009;2(4):231-237. View abstract.

Tsuei, B. J., Bernard, A. C., Barksdale, A. R., Rockich, A. K., Meier, C. F., and Kearney, P. A. Supplemental enteral arginine is metabolized to ornithine in injured patients. J Surg.Res 2005;123(1):17-24. View abstract.

Tuchman, M., Lee, B., Lichter-Konecki, U., Summar, M. L., Yudkoff, M., Cederbaum, S. D., Kerr, D. S., Diaz, G. A., Seashore, M. R., Lee, H. S., McCarter, R. J., Krischer, J. P., and Batshaw, M. L. Cross-sectional multicenter study of patients with urea cycle disorders in the United States. Mol.Genet.Metab 2008;94(4):397-402. View abstract.

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L-arginine – Mayo Clinic

Overview

L-arginine is an amino acid that helps the body build protein.

Your body usually makes all the L-arginine it needs. L-arginine is also found in most protein-rich foods, including fish, red meat, poultry, soy, whole grains, beans and dairy products.

As a supplement, L-arginine can be used orally and topically. It can also be administered intravenously (IV).

Because L-arginine acts as a vasodilator, opening (dilating) blood vessels, many people take oral L-arginine to treat heart conditions and erectile dysfunction.

Evidence

Research on the use of L-arginine for specific conditions shows:

• Angina. Studies suggest that L-arginine might decrease symptoms and improve quality of life in people with a mild to severe form of this type of chest pain.
• High blood pressure (hypertension). Some research has shown that oral L-arginine can lower blood pressure in healthy people, people with mild blood pressure elevation and diabetes, and in people with a type of high blood pressure that affects the arteries in the lungs and the right side of the heart (pulmonary hypertension). Infusions of L-arginine also appear to lower blood pressure in people with hypertension.
• High blood pressure during pregnancy. Some studies show that L-arginine infusions may lower blood pressure in pregnant women who develop high blood pressure.
• Preeclampsia. L-arginine infusions may lower blood pressure in women with this pregnancy complication. Some research shows that taking oral L-arginine might help prevent preeclampsia in pregnant women.
• Erectile dysfunction. Taking oral L-arginine might improve sexual function in men with erectile dysfunction due to a physical cause.
• Peripheral arterial disease (PAD). When taken orally or by infusion for a short period of time, L-arginine may improve symptoms and blood flow in people with this circulatory condition.

Our take

Generally safe

L-arginine is considered to be generally safe. It might be effective at lowering blood pressure, reducing the symptoms of angina and PAD, and treating erectile dysfunction due to a physical cause.

However, if you take a blood pressure drug, talk to your doctor before using L-arginine.

Safety and side effects

Using L-arginine orally or topically is generally considered safe.

Oral use of L-arginine might cause:

• Nausea, abdominal pain and diarrhea
• Bloating
• Gout
• Headache
• Allergic response
• Airway inflammation or worsening of asthma symptoms

L-arginine isn’t recommended for people who have had a recent heart attack due to concerns that the supplement might increase the risk of death.

L-arginine can worsen allergies or asthma. Use the supplement with caution if you have these conditions.

Be careful about taking L-arginine if you’ve had cold sores or genital herpes. Too much L-arginine in your system can potentially trigger the virus that causes those conditions.

Interactions

Possible interactions include:

• Anticoagulants and anti-platelet drugs, herbs and supplements. These types of drugs, herbs and supplements reduce blood clotting. Taking L-arginine with them might increase the risk of bleeding.
• Blood pressure drugs, herbs and supplements. L-arginine might lower blood pressure in people who have high blood pressure. Combining use of L-arginine with a blood pressure drug, herb or supplement might increase the risk of blood pressure becoming too low.
• Diabetes drugs, herbs and supplements. L-arginine might decrease blood sugar levels in people with diabetes. If you’re taking diabetes drugs, herbs or supplements, your dosage might need to be adjusted.
• Isoproterenol (Isuprel). Use of this heart medication with L-arginine might cause your blood pressure to become too low.
• Nitrates. Use of this chest pain medication with L-arginine might cause your blood pressure to become too low.
• Water pills (potassium-sparing diuretics). Don’t take L-arginine with amiloride (Midamor), spironolactone (Aldactone, Carospir) or triamterene (Dyrenium). These medications can increase potassium levels, increasing the risk of developing a higher than normal level of potassium in your blood (hyperkalemia).
• Sildenafil (Revatio, Viagra). Use of this erectile dysfunction medication with L-arginine might cause your blood pressure to become too low.

Feb. 04, 2021

Show references

1. L-arginine. Natural Medicines. https://naturalmedicines.therapeuticresearch.com. Accessed Dec. 20, 2020.
2. L-arginine. Facts & Comparisons eAnswers. https://www.wolterskluwercdi.com/facts-comparisons-online/. Accessed Dec. 20, 2020.
3. Arginine hydrochloride. IBM Micromedex. https://www.micromedexsolutions.com. Accessed Dec. 10, 2020.

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The Daily Therapy With L-Arginine 2,500 mg and Tadalafil 5 mg in Combination and in Monotherapy for the Treatment of Erectile Dysfunction: A Prospective, Randomized Multicentre Study

Abstract

Introduction

A synergistic effect of the combination therapy tadalafil plus L-Arginine is conceivable in patients affected by erectile dysfunction (ED).

Aim

To evaluate the effectiveness and tolerability of tadalafil 5 mg and L-Arginine 2.5 grams in monotherapy and combination therapy.

Methods

Recruited patients completed the International Index of Erectile Function – Erectile Function domain (IIEF-EF) and Sexual Encounter Profile diaries completed at baseline and after treatment. The survey was randomized into 3 groups with an equal allocation ratio. Group A received daily L-Arginine 2,500 mg, group B received daily tadalafil 5 mg, and group C received both daily L-Arginine 2,500 mg plus daily tadalafil 5 mg. The duration of therapy in all 3 groups was 12 weeks. Safety was assessed by evaluating all reported treatment-emergent adverse events.

Main Outcome Measure

The main outcome measure was the change in IIEF-EF score and in per-patient percentage of “yes” responses to Sexual Encounter Profile Question 3 from baseline to after treatment.

Results

300 eligible patients were enrolled, and 100 subjects for each group were allocated. Based on the IIEF-EF score, the participants were divided into 3 categories: severe, moderate, and mild ED. IIEF-EF score increased in group A from 15 ± 7 to 18.1 ± 9.2, in group B from 14.8 ± 6.9 to 20.8 ± 7.3, and in group C from 14.9 ± 7.1 to 22 ± 7.5. In mild ED group, the mean IIEF-EF score increased from 22.1 ± 2.2 to 27.5 ± 2.3 in group A; from 22.1 ± 2.2 to 27.8 ± 2 in group B, and from 22.2 ± 2.2 to 29.3 ± 0.9 in group C. We report a total of 11, 53, and 67 cases of adverse events in group A, B, and C respectively.

Conclusions

Combination therapy was superior to monotherapies.

Gallo L, Pecoraro S, Sarnacchiaro P, et al. The Daily Therapy With L-Arginine 2,500 mg and Tadalafil 5 mg in Combination and in Monotherapy for the Treatment of Erectile Dysfunction: A Prospective, Randomized Multicentre Study. Sex Med 2020;8:178–185.

Key Words

Erectile Dysfunction

L-arginine

Tadalafil

Combination Therapy

Recommended articlesCiting articles (0)

View Abstract

© 2020 The Authors. Published by Elsevier Inc. on behalf of the International Society for Sexual Medicine.

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L-Arginine and Viagra Drug Interactions

This report displays the potential drug interactions for the following 2 drugs:

• L-Arginine (arginine)
• Viagra (sildenafil)

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Interactions between your drugs

Using arginine together with sildenafil may have additive effects on dilating your blood vessels and lowering blood pressure. You may experience increased side effects such as dizziness, lightheadedness, fainting, flushing, and headache. Let your doctor know if you develop these symptoms and they do not go away after a few days or they become troublesome. Avoid driving or operating hazardous machinery until you know how these medications affect you, and use caution when getting up from a sitting or lying position. You may need a dose adjustment or your blood pressure checked more often if you take both medications. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

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Drug and food interactions

If you are receiving therapy with sildenafil you should avoid the regular consumption of large amounts of grapefruits and grapefruit juice. Grapefruit can raise the levels of sildenafil in your body and delay the time it takes for the medication to work. Do not increase or decrease the amount of grapefruit products in your diet without first talking to your doctor.

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Therapeutic duplication warnings are only returned when drugs within the same group exceed the recommended therapeutic duplication maximum.

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Combined Intravenous Sildenafil and l -Arginine Administration in a Porcine Animal Model: Hemodynamic Safety Profile and Effects on Coronary Blood Flow

The salient finding of our study is that combined IV administration of sildenafil and l-arginine in a porcine animal model is safe, well tolerated, and has at least additive effects on the LAD artery blood flow and CO (Tables 2, 3; Fig. 2). None of the animals had any adverse hemodynamic changes requiring intervention (Tables 2, 3; Fig. 2). The results appear to support our hypothesis that simultaneous application of both drugs may have dose-sparing effects. This finding is significant as patients undergoing open-heart surgery are often in a tenuous hemodynamic status. Co-administration of l-arginine and sildenafil may allow a safe and prophylactic usage that increases endothelium-dependent CBF while preventing vasospasm and ischemia.

Concurrent Sildenafil and l-Arginine Infusion

Following our study proving the concept of synergistic vasodilatory effect of sildenafil and l–arginine in an in-vitro porcine internal mammary artery model [12], our group focused on investigating the combination effect in an in-vivo porcine model. No previous study has examined the effects of concurrent IV sildenafil plus l-arginine administration on coronary circulation in a large animal model reflecting the acute setting of open-heart surgery. The current study supports and expands our prior results by demonstrating that l-arginine in the presence of sildenafil induces significant and concentration-dependent increases in LAD artery blood flow (Fig. 2; Table 3), while it is safe and well tolerated (Fig. 2; Table 2). Importantly from a clinical perspective, MAP, CVP, CVR, SVR, and HR remained relatively stable. It is well established that CBF is dependent on multiple factors, including BP, HR, and CVR, for example. The increase in CBF was likely a combination of the small decrease in CVR combined with the small increase in MAP.

The effect of sildenafil alone on LAD flow was comparable to the effect measured after the fifth l-arginine dose administered alone (Table 2). Boluses of l-arginine in the presence of sildenafil increased significantly the blood flow (at bolus #4 and #5) showing the additive action of the drugs. This study did not examine the time course of offset of the effects of l-arginine or sildenafil. The decreases in CVR persisted throughout the infusions. We waited 2 h for them to resolve prior to subsequent tests. A further study would be needed to give the exact time course of offset of the effects.

Synergistic effects of sildenafil and l-arginine have already been described in a rabbit corpus cavernosum [19] and in pulmonary vasculature [14, 20, 21]. Life-threatening pulmonary hypertension in pregnancy was treated successfully with concomitant sildenafil plus l-arginine use [20]. The combination of sildenafil with l-arginine, both at lower doses than when administered alone, may have important clinical applications, as both drugs have side effects [16, 17, 22, 23]. A reduction in the amount of sildenafil and l-arginine doses may therefore lower the risk of adverse events.

For a medication to be clinically useful, the hemodynamic effects must be controllable. This study demonstrated that there were small but statistically significant decreases in SVR with l-arginine that were not large enough to cause clinically significant hemodynamic problems. Combinations of l-arginine and sildenafil did not have statistically significant changes in either MAP or SVR providing a safe hemodynamic profile.

l-Arginine Hydrochloride Infusion (Alone)

Our results support the current view of hemodynamic changes with an IV infusion of l-arginine alone, including peripheral vasodilatation, concentration-dependent decreases in SVR and MAP, an increase in CO, as well as mitigating change in HR [24,25,26,27]. Similar to our study, Bode-Boger et al. examined the pharmacokinetic-pharmacodynamic relationship of l-arginine after a single IV infusion of 30 g, and found a significant dose-dependent decrease in blood pressure and total vascular resistance [27].

Our previous work demonstrated that the effects of l-arginine on coronary circulation cannot be predicted from systemic vascular response [11]. Consequently, we used transit time flow meters to quantitatively measure blood flow and resistance of the LAD artery. We found both coronary vasodilatation and an increase in LAD artery blood flow when an IV infusion of l-arginine was administered. Both effects were significant and concentration dependent. The increase in LAD artery blood flow was nearly twice as strong as the changes in CO. This is consistent with our previous findings showing that l-arginine has more selective vasodilatory effects on coronary vasculature than systemic vasculature [11]. Moreover, quantitative human coronary angiography studies demonstrated that both IV and intracoronary l-arginine infusions induce dilatation of coronary arteries [28,29,30,31]. Finally, l-arginine has been shown to restore the acetylcholine-induced increase in blood flow in patients with impaired endothelium-dependent dilatation of coronary microcirculation, such as in hypocholesteremia [10]. Consistent with the endothelium-dependent NO-mediated mechanism of a vascular tone model, l-NAME, a NO synthesis inhibitor, produced a reduction in LAD artery blood flow in a rat animal model [32]. The effects were then reversed with an IV administration of l-arginine [32]. The stimulation of the l-arginine-NOS-NO pathway is regarded as the dominant mechanism behind the action of l-arginine [31, 33].

l-Arginine is converted by NOS into l-citrulline and NO, making l-citrulline a marker of the production of NO. We measured l-arginine and l-citrulline concentrations from a radial artery sample. The l-citrulline plasma concentration was significantly correlated with the l-arginine plasma concentration at each dose suggesting that l-arginine was converted into l-citrulline while additionally producing NO. However, the l-citrulline plasma concentration did not show a correlation with the l-arginine plasma concentration nor with hemodynamic clinical effects among doses, despite the close temporal pattern between the l-arginine plasma concentration and hemodynamic effects [27, 34, 35]. This discrepancy may be due to the saturation of other l-arginine metabolic pathways, such as l-arginine metabolism by the hepatic urea cycle [34].

Mannitol Infusion

Hypertonic ionic (saline) and nonionic (glucose) solutions have been reported to reduce coronary vascular resistance in direct relation to hyperosmolality [36]. In our study, the administration of 30 g of l-arginine led to an increase in osmolality similar to the subsequent mannitol infusion. However, the administration of l-arginine was associated with a significantly higher increase in LAD artery blood flow than the mannitol infusion (14.4 mL/min vs 5.5 mL/min, p < 0.01). The change in CBF after an l-arginine infusion was 2.6 times the change expected for a similar change in osmolality; this suggests that hyperosmolality is only a minor factor in l-arginine hemodynamic effects [11].

Sildenafil Citrate Infusion

Studies examining the sildenafil effects on systemic, pulmonary, and myocardial hemodynamics used an oral route or slow IV administration [37,38,39,40,41,42,43]. Unlike other vasoactive drugs, there is a paucity of data on the hemodynamic effects of a rapid IV bolus administration of sildenafil. In the present study, we administered sildenafil intravenously as a bolus of 100 mg over 1 min. The hemodynamic response 1–2 min following the injection was characterized by significant arterial vasodilatation (reduced SVR and MAP) and tachycardia, which led to a short yet significant increase in CO. The coronary circulation mirrored this with a significant decrease in CVR while causing a significant increase in LAD artery blood flow despite the markedly decreased MAP. This was followed by rapid normalization of CO, a slow return of HR back to baseline, and relatively unchanged vasodilatation. There was a decrease in LAD artery blood flow despite a stable MAP. The results appear to support the reported effects of sildenafil, characterized by a vasodilatation-induced reduction in blood pressure [37]. In fact, the peak reduction in blood pressure has been shown to positively correlate with peak sildenafil plasma concentrations [37, 44] followed by a slow return to baseline levels. Phillips et al., using a 100-mg sildenafil oral dose, demonstrated an increase in sympathetic nerve activity selective for a vascular sympathetic drive [43]. The sildenafil oral dose of 100 mg was found to have equivalent peak plasma concentrations when compared to an IV infusion of 40 mg over 40–60 min [37]. In our study, we used a 100-mg sildenafil IV dose infused over 1 min. This higher amount is likely associated with our 2.5 times higher peak plasma concentrations than reported in the study by Phillips et al. [43].

Our findings suggest that even large IV sildenafil doses are well tolerated and not associated with major adverse hemodynamic events. However, our results also suggest that sildenafil administration is associated with tachycardia, possibly owing to the described increase in sympathetic activity [43]. Considering that many patients who may benefit from sildenafil are characterized by ischemic heart disease, a slower administration over a prolonged period should be considered. Jackson et al. described that IV infusion of 40 mg over 60 min was associated with no adverse events [37].

Limitations

The use of an animal model is an important step in determining the safety profile of the combined use of l-arginine and sildenafil; however, this study has limitations.

There are several limitations to our measurement of CBF and CVR:

• These measurements were performed only at the LAD vascular distribution; they were surrogates for the whole coronary circulation. This was done because to measure total coronary vascular resistance, one would need to measure total CBF, which would require a flow probe on the left main coronary artery and the right coronary artery. Placing a probe on the left main coronary artery is technically challenging. Thus, the decision was made to measure CVR of the LAD vascular bed.

• We placed a catheter to measure CVP. We did not place a piezoelectric catheter into the left ventricle to measure left ventricular diastolic pressure. Typically, CVR would be CVR = [(aortic diastolic pressure − left ventricular diastolic pressure)/total CBF] × 80. In a healthy pig, because the ventricular function is not impaired, the CVP provides information on right ventricular end-diastolic pressure, which parallels changes in left ventricular end-diastolic pressure. Central venous pressure was used as a surrogate of left ventricular diastolic pressure to avoid having to place a left ventricular piezoelectric or Millar catheter in the left ventricle.

• Coronary blood flow to the left ventricle occurs during diastole. The pressure gradient between the aorta and left ventricle is zero during systole resulting in zero CBF in the LAD during systole. Coronary vascular resistance was only calculated during diastole secondary to the zero-flow state in the LAD during systole.

One unexpected finding was the change in heart rate from 106 ± 5.6 beats/min to 140 ± 6.5 beats/min before sildenafil infusion (Fig. 3e). The elevated heart rate persisted throughout the sildenafil and l-arginine post-sildenafil infusions. Pancuronium, which was given to the animals multiple times throughout the study, is known to increase HR in a dose-dependent manner [45]. Possible dehydration and late effects of l-arginine may also contribute to the increase in HR. Another limitation was that l-arginine lowered SVR in the pigs in this study, but it has had little effect in post-bypass patients [11]. One explanation could be that there is already a low SVR in post-bypass patients, thus the addition of l-arginine has minimal effects. Another reason is that the pig vasculature in the current study was not dilated prior to l-arginine infusion. Administration of l-arginine could therefore lead to vasodilatory response and lower SVR. Along the same lines, the difference in the degree of atherosclerosis between patients undergoing open heart revascularization and the large animals used in this study, further limits the translation of the results to humans. Finally, the long-term safety issues were not assessed in this study.

Can L-Arginine Help With ED?

Medically reviewed by Hims Updated 9/15/2017 4 min read

L-arginine is an amino acid that’s available as a health supplement. Widely used for heart health conditions such as high blood pressure and coronary artery disease, some people believe that l-arginine could potentially help to treat erectile dysfunction (ED).

Many of these claims come from natural health websites that position L-arginine as a natural alternative to ED drugs such as sildenafil (Viagra), vardenafil (Levitra) and tadalafil (Cialis).

Right now, the scientific evidence showing that L-arginine is effective is very limited, with several studies producing different results. However, L-arginine can potentially have other benefits that make it a useful supplement for certain people.

As with all drugs and supplements, L-arginine should only be taken after speaking to your doctor about its potential effects on your health.

The Benefits of L-Arginine

L-arginine, or arginine, is a semi-essential amino acid that’s used for a variety of purposes. The body uses l-arginine for healing wounds, maintaining hormone production, promoting a healthy immune system and helping the kidneys filter waste.

L-arginine is also the immediate precursor of nitric oxide — an important molecule for dilating the blood vessels and improving blood flow. This makes it a popular supplement for conditions such as high blood pressure.

Because nitric oxide is essential for developing an erection, L-arginine is viewed as a potential non-pharmaceutical treatment for ED.

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Is L-Arginine Effective at Treating ED?

As with all supplements, it’s important to take the claims made by manufacturers of l-arginine products with a grain of salt.

Right now, there aren’t many studies examining the effects that L-arginine could potentially have on erectile dysfunction. The few studies that are available show mixed results:

• One study from 1999 found that L-arginine was no more effective as a first-line treatment for impotence than a placebo.
• Interestingly, another study from 2003 showed that L-arginine, when used in combination with Pycnogenol, caused a significant improvement in sexual function in men with ED.

Unlike ED drugs, L-arginine supplements aren’t subject to as many regulations regarding safety or efficacy. If you use medication for ED — such as sildenafil, vardenafil or tadalafil — it’s best not to consider L-arginine supplements as a potential replacement.

So, is L-arginine effective at treating ED? Right now, it simply isn’t possible to say. The current studies show mixed results, making it impossible to conclusively state that L-arginine has any real benefits as an erectile dysfunction treatment.

Does this mean that L-arginine is worthless as a supplement? Of course not. Like many other supplements, the fact that L-arginine isn’t proven to be effective as an ED treatment doesn’t mean that it can’t potentially have other health benefits.

Should You Use An L-Arginine Supplement?

L-arginine has very specific effects on the body. As a supplement, its primary benefit is that it can potentially lower both systolic and diastolic blood pressure — a benefit that’s backed up by medical studies.

It’s important to note that most people produce enough L-arginine naturally. Deficiencies are rare, meaning that you probably don’t need to take an L-arginine supplement unless you’ve been specifically told to take it by your doctor.

It’s also important to know that L-arginine might not be the best treatment for lowering high blood pressure. If you have high blood pressure, you should always seek advice from your doctor before using any supplement or medication.

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This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.

Does L-Arginine Work Like Viagra? (+Best Place To Buy) 2020

L-Arginine works similarly to Viagra (Sildenafil) by relaxing blood vessels. Relaxed blood vessels allow the appropriate amount of blood to flow to the penis. This process is necessary for achieving and maintaining a hard erection. L-Arginine is also cheaper than Viagra (Sildenafil) per dose.

How do L-Arginine and Viagra (Sildenafil) work?

L-arginine is an amino acid that creates proteins and transforms into a gas nitric oxide in the body. Gas nitric oxide relaxes blood vessels, which in turn improves blood flow to the arteries of the penis. This improves erectile function.

L-arginine works similarly to Sildenafil (Viagra), which also focuses on relaxing blood vessels.

Sildenafil (Viagra) is prescribed to treat erectile dysfunction. It relaxes blood vessels and increases blood flow to the penis. Sildenafil also controls an enzyme called phosphodiesterase type-5 to sustain an erection.

What are the side effects of L-Arginine and Viagra (Sildenafil)

In general, both L-Arginine and Sildenafil are safe to take. However, like most drugs and supplements, there are some side effects to watch out for.

L Arginine common side effects:

• Increased risk of bleeding
• Unhealthy imbalance of potassium in the body
• Change in blood sugar levels
• Decreased blood pressure

Be careful about taking L-arginine if you’re taking ED drugs already, such as Sildenafil (Viagra) or Tadalafil (Cialis). L-arginine may cause your blood pressure to drop temporarily. If you have low blood pressure already or take medications to control your blood pressure, avoid L-arginine, or consult a doctor before trying it.

Viagra (Sildenafil) common side effects:

• Flushing (warmth, redness, or tingly feeling)
• Headache, and dizziness
• Heartburn, nausea, or upset stomach
• Abnormal vision (blurred vision, changes in color vision)
• Runny or stuffy nose, or nosebleeds
• Insomnia
• Muscle pain, and/or back pain

Which is the best option for you?

Both L-Arginine and Viagra (Sildenafil) are effective treatments for ED with their own advantages and disadvantages. We recommend Viagra (Sildenafil) over L-Arginine because Viagra (Sildenafil) improves ED in two ways, as opposed to just relaxing blood vessels.

If you’re experiencing one or more symptoms of ED, consider these 2 options to get a prescription.

• Visit your doctor: You can see your doctor to talk about your symptoms. It’s best to go to a doctor that you feel comfortable speaking to about your sex life because face-to-face consultations can feel uncomfortable and invasive.
• Book a quick online consultation: Speak with one of our independent, online physicians. This is a safe, easy, and more comfortable alternative to making a traditional doctor’s appointment and then picking up your prescription from the pharmacy. Have a potentially uncomfortable conversation from the comfort and convenience of your own home. Plus, we ship your prescription straight to you. It’s never been easier!

Don’t let ED ruin your fun. Contact us, today!

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Friends, continuing the conversation about sports supplements, I decided to devote today’s topic to arginine. Discuss its properties, dosage regimens, dosages. Arginine is a conditionally essential amino acid. It is used in sports nutrition as a nitrogen donor. In practice, this means better blood circulation of the working muscles during training, the so-called pump or pumping in Russian.

To write an article on this topic, I was prompted by the statement from the sportwiki that the effectiveness and feasibility of taking arginine in bodybuilding in order to improve muscle nutrition and achieve pumping remains in doubt.I would like to clarify the situation somewhat. Perhaps I’ll start with the last statement, with which I strongly disagree. Personally, I have no doubt that arginine is very effective for pumping.

I will describe the use of arginine in the training process from my own practice. First you need to decide on the choice of the form of arginine. It can be powder, tablets, or capsules. The powder is, of course, the most affordable option, and it was with it that I began my experiments with arginine.However, as it soon became clear, taking arginine regularly in powder form is a real torture. It’s all about its disgusting taste and no less awful smell. Do not think that I am some kind of sissy and can not endure a not very pleasant taste. I take bitter tasteless BCAAs, acidic acetyl L-carnitine, and even the very bitter CEE (creatine ethyl ester) does not cause any problems when taking it, but the powder form of L-arginine is a very special case. Drinking it regularly so as not to twist it turned out to be an extremely difficult task.If, despite all the warnings, you still decide to choose this form, then I advise you to use orange juice for breeding, which somehow masks its taste. I didn’t torture myself for too long and after some experience I took arginine tablets. And basically all the experiments with the dosages and the time of admission were carried out with him. About dosages. I started taking powdered arginine from 5 grams as recommended on my package. Now the label has been changed and for some reason the new recommendation has become 4.6 grams.If anyone knows the reason for such “significant” changes, please unsubscribe in the comments.

The effect was felt immediately, from the very first dose. During training, the blood supply to the working muscles significantly increased. Later, having switched to the pill form of arginine, he started taking it with 3 grams, gradually increasing to 7 grams. As a result, it was possible to find out that a single dosage of 5 grams is still optimal (exceeding this dosage unnecessarily lowered blood pressure), however, as it turned out, it is more effective to take it not 40 minutes before training, but 1.5-2 hours.When calculating an individual dosage, it must be borne in mind that arginine is part of almost any pre-workout complex. It should also be borne in mind that in order to achieve the desired result, it is important that the intake of arginine is carried out on an empty stomach. Yes, this is not always convenient, but otherwise the efficiency will be significantly reduced, or it will be completely absent.

Other properties of arginine, such as an increase in the level of growth hormone during a night’s sleep (when taking arginine before bedtime), improving the transport of creatine to muscles (when taking arginine with creatine together) will not be described in this article, since these effects are difficult to confirm or refute in their own practice at the level of sensations.
As far as improving muscle nutrition with arginine is concerned, it seems quite logical, due to the obvious increase in blood flow to working muscles. Be that as it may, in any case, the increase in pumping taking place, a good pump is already a sufficient argument in favor of taking arginine. It is a very pleasant feeling and provides powerful psychological support during training.

Arginine also has one property that manufacturers do not indicate on the packaging, however, which is so pronounced that it leaves no doubt about its presence.The fact is that arginine has a tangible effect on erectile function, thereby significantly increasing the severity of sexual sensations. The dosages are the same, about 5 grams per dose, 1.5-2 hours before you know what. The effect is similar to Viagra, however, unlike Viagra, arginine is devoid of such an unpleasant side effect as headache. Guys, take a note.

That’s all for today that I would like to tell you about. I think personal experience is always more interesting than dry scientific articles. If anyone has any questions, write in the comments or in a personal.

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This drug is a natural activator of natural potency, harmless to health, without side effects.It provides a firm and lasting erection, enhancing libido. Took lozenges for more than 2 weeks. The result is still there! There were no misfires in bed for a month already. Although we have sex with my wife almost every day, which is impossible at my age! Composition: carriers of sorbitol and isomalt, acidity regulator citric acid, L-arginine, plant extracts (yohimbe bark, ginseng root, guarana fruits, damiana, orange, pumpkin seeds, artichoke leaves), anti-caking agents calcium stearate and silicon dioxide.Contains sweeteners. May have a laxative effect if consumed in excess. Sooner or later, all men begin to complain of problems with potency. It is very important to identify the disorder in a timely manner and begin treatment. This is the only way to get rid of dysfunction quickly enough, without consequences. Fish oil for potency prevents the occurrence of prostatitis, as it is. Fish oil for potency helps to increase the concentration of testosterone. The benefits of fish for men. Besides fat, it is possible to increase libido.Fish oil is one of the components necessary in the fight against impotence, which can be caused by mental disorders, increased anxiety. Fish oil and potency are closely related to each other – proven to be less common from. Updated date: 2019-11-20. Sooner or later, all men begin to complain of problems with potency. It is very important to identify the disorder in a timely manner and begin treatment. Fish oil capsules for men: unproven benefits. Fish oil supplements are marketed by manufacturers as an easy way to protect the heart, relieve inflammation, improve mental health, and prolong life.Such statements are one of the reasons why only US residents. How does fish oil affect potency in men? Fish oil has a lot of positive reviews from those who have tried it to increase the potency of men and who recommend doctors to restore their health.

Romanova Viagra

With age, I had to deal with such a well-known diagnosis of many men as prostatitis. With his wife, sex life was absent for over 6 months. The treatment did not lead to any results.After changing the doctor, the new specialist recommended JaviMax. After a 2-week course, I simply did not believe that I had completely restored my masculine strength. Cialis – pills for the correction of erectile dysfunction, an analogue of Viagra and Levitra. The license is held by Eli Lilly Vostok. (Switzerland), manufacturer Lilly del Caribe Inc. Generic Cialis is an analogue of the original remedy for men, namely maintaining potency. The only difference between them is the price. Pills to improve the potency of Cialis will help to correct the situation.The main active ingredient of the drug Cialis is tadalafil, which helps with sexual disorders and impotence in men. An agent for the treatment of erectile dysfunction, is a reversible selective inhibitor of specific PDE5 cGMP. When Sexual Arousal Among the drugs for the treatment of erectile dysfunction, Cialis has established itself at its best. But this applies only to cases of single use in order to improve potency. Cialis is a well-known medical product that is designed to treat problems associated with erectile dysfunction disorders.The product is produced in Spain and belongs to the group of PDE-5 inhibitors. Description of the drug Cialis: composition and instructions for use. Shelf life of the drug Cialis. 3 years. Do not use after the expiration date. Decreased sexual potency in men. Sexual dysfunctions in men. Sexual dysfunctions. Weak potency. Decreased potency. Cialis is a modern remedy for erectile dysfunction. Cialis analogs are both drugs for the potency of the PDE5 inhibitor group – Viagra, Levitra, Stendra and Zydena, and generics containing tadalafil.Generic Cialis 5 mg. Cialis generic search problem. These drugs include Cialis tablets. The drug is used to treat impotence of any nature. Taking Cialis (reviews of men) for potency, a full erection occurs within 13 minutes after use. But the maximum period when an erection is achieved is 1 hour. Romanova Viagra . Viagra went out. Reviews, instructions for use, composition and properties. This drug to increase the potency of men without side effects and has no contraindications.A single dosage of these pills to increase potency in men after 40 or younger is 10 mg once a day. Begins to work half an hour after ingestion. What drugs are there for potency? What were we guided by when distributing places in the TOP? The percentage of men who are satisfied with an erection after taking a pill (statistics Pharmacy Today – the official magazine. Drugs for a quick increase in potency for men: 31 best remedies. Victor Rumyantsev. There are many drugs on the modern pharmacological market that quickly improve and increase potency in men.Before buying a product, you need to understand its mechanism. The question of which drugs are suitable for potency without side effects is decided individually. It is necessary to choose safe drugs to increase potency in men. Natural preparations are recommended for up to 40 years. Tablets for potency for men of the IFDE-5 group with a high rating. TOP-5 safe drugs for potency without side effects. Homeopathic medicines and herbal supplements do not have side effects. These drugs are used to restore the lungs.How to choose the best drugs for male potency at the best price-quality ratio. These are fairly modern and relatively safe drugs, however. suitable for men and women over 40; eliminates inflammatory processes; shown at. The best drugs for male potency and quality improvement. The tool is indicated for admission to men for the purpose of prophylaxis and complex. The safest pills for potency without contraindications – Impaza; Quickly eliminates erectile dysfunction and provides.For a modern man, especially after 40-45 years old, good potency is an exception rather than an ordinary fact. Ruthless statistics claim that every third Russian before this age periodically suffers a fiasco in bed, and after 50, every Tuesday. What drugs to prefer a man over 50 years old. When choosing a medicine for impotence for a man over 50 years old, a doctor. According to the reviews of men who took drugs to improve potency, modern medicines demonstrate a good therapeutic effect.Most people follow the course. To date, drugs that increase the potency of men are in great demand, so the arsenal. In addition, over the past few years, drugs for potency based on medicinal plants have become popular. Inexpensive pills for potency: which one to choose for a man? 251999 40. These are also quite cheap pills for male potency, produced in packs. The last in the list of inexpensive drugs most often used to restore impaired potency is Vizarsin.Today there are a large number of means to increase potency. They are not only ordinary ones. To do this, we have compiled a rating of the TOP 7 best drugs to increase potency in men: contraindications. Means for stabilizing the potency of men are described. The daily dose is 1 tablet. Action – within 40 minutes after application. In the rating of drugs for potency in men, ten popular folk remedies: 10. Eleutherococcus. Rich in nutrients that enhance.Review of drugs for potency. There are many drugs on the modern pharmaceutical market. The problem with erection is a rather sensitive topic for men, not everyone shares it. I am only 40 years old, but I also faced a bad erection, or harmful conditions at work, myself.

90,000 “Viagra” for women enters the market – Business – Kommersant

Experts from the Federal Food and Drug Administration (FDA) have recommended the approval of the drug flibanserin, designed to combat low sex drive in women.Until now, the FDA has refused to approve the invention of Sprout Pharmaceuticals, considering it insufficiently effective.

The Expert Council of the Federal Food and Drug Administration of the USA recommended the approval of the drug flibanserin for sale in the USA, which has already received the unofficial name of “female Viagra”. A drug developed by Sprout Pharmaceuticals Inc is designed to combat low sex drive in women. The company expects to receive final approval for the drug by the end of this year.

As follows from the reports of the American media, in particular the Bloomberg agency, 18 members of the committee spoke in support of the approval of the flibanserin, and six people were against. Previously, the FDA refused to authorize the sale of the drug in the United States, citing its low effectiveness. The company reapplied for approval, adding new data from clinical trials. This time, experts felt that the drug’s benefits outweighed its potential side effects, chief among which is loss of consciousness.

“We would all like the drug to be better, but in general, even the limited effect of it outweighs all the real risks associated with taking it,” Amy Whittaker, an expert committee member and assistant professor of obstetrics and gynecology at the University of Chicago, said in an interview with Bloomberg. In turn, another member of the committee and sexologist Marianne Brandon, recognizing the limited effect of the drug, nevertheless declared its absolute necessity. “My patients and patients will jump for joy, even if it’s just one more sexual experience a month.It’s a question of quality of life. ” The committee’s recommendation states that flibanserin, which Sprout plans to market under the brand name Addyi, should only be sold on prescription.

Until now, there has not been a single drug in the United States that would be aimed at increasing female libido. At the same time, after the appearance in 1998 of the Viagra drug of the Pfizer corporation, as well as Cialis from Eli Lilly, a lot of similar drugs appeared on the market. According to Bloomberg experts, Viagra and Cialis alone, the market’s best sellers, totaled $ 3.98 billion last year.The potential market for similar drugs for women is estimated at $ 2 billion per year.

Sprout Pharmaceuticals is a privately held, non-publicly traded company. Palatin Technologies Inc – the company that announced the start of the last stage of clinical trials of a similar drug – bremelanotide – rose 22% after the announcement of the FDA expert committee’s decision.